Written Answers Nos. 1017-1037
1017. Deputy Ken O'Flynn asked the Minister for Health whether she was advised, at any point between 2020 and 2025, that there was no Department of Health or HSE policy governing the collection, verification, or publication of data relating to gender identity services for children and young people; the dates on which any such advice was provided; the officials or offices that provided that advice; and the actions, if any, she directed in response. [9328/26]
View answer1018. Deputy Ken O'Flynn asked the Minister for Health whether her Department conducted or commissioned any formal governance, risk, or child safeguarding assessment addressing the absence of routine data collection, outcome monitoring, or longitudinal follow-up in paediatric gender identity services prior to approving or revising policy or models of care since 2020; and if not, to outline the rationale for proceeding with policy development in the absence of such assessments. [9329/26]
View answer1050. Deputy Ken O'Flynn asked the Minister for Health whether her Department has formally approved any national governance or clinical policy framework for gender identity services for children and young people provided by the Health Service Executive; if so, the date of that approval; and if not, the reason no Department-approved framework is currently in place for services involving minors. [9483/26]
View answer1051. Deputy Ken O'Flynn asked the Minister for Health the date of the most recent Department-led review, audit, or evaluation of governance and safeguarding arrangements for gender identity services for children and young people; whether that review was internal or external; and whether its findings were provided to her Department for policy or regulatory action. [9484/26]
View answer1052. Deputy Ken O'Flynn asked the Minister for Health whether her Department has issued mandatory national safeguarding, clinical governance, or diagnostic standards for gender identity services for children and young people; whether compliance with such standards is a condition of service provision; and how compliance is monitored or enforced at national level by her Department. [9485/26]
View answer1053. Deputy Ken O'Flynn asked the Minister for Health whether her Department is aware that structured national datasets for gender identity services for minors, including referral volumes, diagnostic profiles, treatment pathways, and outcomes, are not currently in place; and whether she considers the absence of such datasets compatible with evidence-based healthcare planning and safeguarding obligations. [9486/26]
View answer1054. Deputy Ken O'Flynn asked the Minister for Health whether she has issued, or intends to issue, a ministerial policy direction requiring the establishment of national datasets for gender identity services for children and young people; and if so, the proposed scope, governance arrangements, and timeline for implementation. [9487/26]
View answerI propose to take Questions Nos. 1017, 1018, 1050, 1051, 1052, 1053 and 1054 together.
As the Deputy will be aware and as set out in the Programme for Government 2025, this Government is committed to ensuring a transgender healthcare service that is based on clinical evidence, respect, inclusiveness and compassion.
It is in this context that my department has provided funding to the HSE in 2024, 2025 and this year for the establishment and development of the National Clinical Programme for Gender Healthcare. This programme is developing an updated clinical Model of Care with the aim of designing clinical pathways to deliver safe and effective health and social care for those seeking gender affirming healthcare services. This work will also inform an implementation plan for its delivery.
In the context of current services, there is no specialist gender service for children and young people (under the age of 16). The current pathway for children and young people is to attend their GP who may refer the patient to their local CAMHS service. The HSE National Clinical Programme for Gender Healthcare will include a clinical framework for the clinical support and management of children and young people in primary, secondary and specialist care settings, and matters such as the collection of clinical data will be considered in the development of this model of care.
Developing a model of care for Gender Healthcare Services is a complex process and the HSE and my department are working closely together to support the process, ensure transparency and keep the patient at the centre of the process.
It is important that the HSE is given time to develop a model of care that is based on the best clinical evidence and that will deliver the best outcomes for persons with gender incongruence or dysphoria.
1019. Deputy Pádraig Rice asked the Minister for Health the steps being taken to ensure urgent access to a treatment where clinicians advise that delay risks irreversible loss of neurological and functional ability (details supplied); if compassionate or exceptional access mechanisms are available while national reimbursement processes are ongoing; the safeguards currently in place to protect such patients from avoidable permanent harm during administrative delays; and if she will make a statement on the matter. [9330/26]
View answerAs this is a service matter and under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines and medical devices, this question has been referred to the HSE for attention and direct reply to the Deputy.
1020. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives, holds, or reviews data relating to the total annual revenue generated from car parking charges at Cork University Hospital; and if so, to provide the figures available to her Department for each of the past five years; and if she will make a statement on the matter. [9344/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1021. Deputy Ken O'Flynn asked the Minister for Health whether her Department has issued any policy guidance, circulars, or directions to the HSE regarding the permitted or intended use of revenue generated from hospital car parking charges; and if so, to outline the expenditure categories to which such revenue may be applied, including maintenance, staffing, capital works, or payments to third-party operators; and if she will make a statement on the matter. [9345/26]
View answer1022. Deputy Ken O'Flynn asked the Minister for Health the governance, reporting, and oversight arrangements in place, by which her Department assures itself that revenue generated from hospital car parking charges is properly accounted for, audited, and used in accordance with public financial procedures; and to outline the specific mechanisms by which such assurance is obtained in respect of Cork University Hospital; and if she will make a statement on the matter. [9346/26]
View answer1023. Deputy Ken O'Flynn asked the Minister for Health to outline the current status of the Programme for Government commitments relating to hospital car parking charges, including daily caps and flexible or reduced-rate parking arrangements; to specify which commitments have been implemented to date; which remain outstanding; the reasons for any delay; and the expected timeline for delivery of outstanding commitments; and if she will make a statement on the matter. [9347/26]
View answer1024. Deputy Ken O'Flynn asked the Minister for Health whether her Department has undertaken, commissioned, or relied upon any assessment, review, or analysis of the impact of hospital car parking charges on patients and families attending large regional hospitals with extensive catchment areas, including Cork University Hospital; and if so, to provide details of such assessments and their findings; and if not, to state whether any such assessment is planned; and if she will make a statement on the matter. [9348/26]
View answer1025. Deputy Ken O'Flynn asked the Minister for Health to outline the process by which her Department reviews, updates, or revises its standard responses to parliamentary questions on hospital car parking policy; and to state whether any substantive policy or administrative changes have occurred since January 2024 that would warrant updated guidance or revised responses; and if she will make a statement on the matter. [9349/26]
View answerI propose to take Questions Nos. 1021, 1022, 1023, 1024 and 1025 together.
Responses to parliamentary questions on hospital car parking charges are informed by ongoing engagement with the HSE and by any relevant developments in the area.
Revenue generated from hospital car parking charges is used for a range of purposes. This might be maintenance and re-investment in parking facilities, including repayment of loans obtained for upgrading such facilities and investment in security. It may also be simply to cover the cost of parking provision more generally, with any additional income being used to contribute to the general hospital budget for provision of care or research.
This Revenue is accounted for at individual hospital level. All relevant Income is included in the HSE’s Annual Financial Statements. These Statements are audited annually by the Comptroller and Auditor General.
Hospitals that charge parking fees are very cognisant of the financial implications of parking costs for patients and their families, particularly for those with long-term illnesses. Consequently, many hospitals have introduced reduced rate parking for long-term patients for whom the payment of the full rate would cause hardship, and all hospitals that charge for parking have a fixed maximum daily rate. The majority of hospitals have some form of exemption or allowances in place such as the option of flexible day passes or multi-trip entry passes for regular hospital attenders, and various concessions based on the type of inpatient.
The Programme for Government 2025 – Securing Ireland’s Future, makes a commitment to explore further ways to reduce hospital car parking charges. This is a reflection of the Government’s appreciation of the financial challenge that can be faced by people in meeting these expenses, in particular where they are frequent users of hospital services. Accordingly, in line with this commitment, the HSE continues to keep all fees and concessions under review, in order to progress any opportunities that will ease the burden for those most affected.
1026. Deputy Ken O'Flynn asked the Minister for Health the total number of residential properties currently owned by the Health Service Executive which are vacant; the number deemed surplus to requirements; the length of time each property has been vacant; and if she will make a statement on the matter. [9367/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1027. Deputy Ken O'Flynn asked the Minister for Health to outline the policy framework governing the retention, disposal, or repurposing of vacant residential properties owned by the Health Service Executive; when this policy was last reviewed; and if she will make a statement on the matter. [9368/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1028. Deputy Ken O'Flynn asked the Minister for Health what formal engagement has taken place between his Department, the Department of Housing, Local Government and Heritage, and the Land Development Agency regarding the potential transfer or reuse of vacant HSE-owned residential properties for housing purposes; and if she will make a statement on the matter. [9369/26]
View answerThe HSE adheres to its statutory obligations and is required to offer surplus assets, including properties for housing, in the first case to the Land Development Agency (LDA) and then to other State stakeholders (including Local Authorities) under Department of Public Expenditure and Reform Circulars 11/15 Protocols for the Transfer and Sharing of State Property Assets & 17/16 Policy for the Property Acquisition and for Disposal of Surplus Property.
The HSE must follow the official process for the disposal of properties by State bodies and agencies. When a HSE property has been vacated by a service it is necessary to establish if it is surplus to requirements and decide to retain the property in the healthcare estates. If the property is to be disposed of, the process hierarchy is set out as follows:
• Offer the property to the LDA via written notification.
• Should the LDA not choose to take up the property, under DPER Circulars 11/2015 & 17/2016 the HSE must then offer the property to other State Stakeholders via the State Property Register.
• Should no other State Stakeholders take up the property, the HSE then places the property for sale on the open market.
In addition to these statutory requirements, my Department engages with the Department of Housing, Local Government and Heritage and the LDA in relevant work and reports such as the State Lands subgroup in the context of Housing for All and in Delivering Homes, Building Communities and the LDA Report on Relevant Public Land.
My Department and the HSE will continue to work collaboratively with all key stakeholders in relation to its surplus assets as part of an all of Government approach to increasing housing stock.
1029. Deputy Ken O'Flynn asked the Minister for Health to identify the principal legal, financial, or administrative barriers preventing the timely reuse or disposal of vacant residential properties owned by the Health Service Executive; the steps being taken to address these barriers; and if she will make a statement on the matter. [9370/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1030. Deputy Ken O'Flynn asked the Minister for Health the annual cost to the State of maintaining vacant residential properties owned by the Health Service Executive, including security, insurance, and maintenance; and if she will make a statement on the matter. [9371/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1031. Deputy Ken O'Flynn asked the Minister for Health whether she has received, requested, or reviewed the expert group assessment commissioned by the HSE Chief Clinical Officer on the implications for Irish gender healthcare services of the final Cass Review; when this assessment was completed; whether it has been submitted to the HSE Chief Executive Officer for consideration; and when she expects this assessment to be published or otherwise made available to the Oireachtas; and if she will make a statement on the matter. [9413/26]
View answer1032. Deputy Ken O'Flynn asked the Minister for Health whether the assessment of the final Cass Review completed by the HSE-appointed expert group will be treated as binding clinical guidance, advisory evidence, or background material only for the purposes of national healthcare policy; whether she has issued or intends to issue any direction regarding its status within the development of the national Model of Care for Gender Healthcare; and if she will make a statement on the matter. [9414/26]
View answerI propose to take Questions Nos. 1031 and 1032 together.
The Cass Report has been reviewed by clinical experts within the HSE at the request of the Chief Clinical Officer and the review is currently under consideration by the HSE.
The provision of proper, appropriate, and integrated gender healthcare services is something that I want to ensure is in place for those who are questioning their gender identity or are experiencing gender incongruence or dysphoria.
As per the Programme for Government 2025, the Government is committed to ensuring a transgender healthcare service based on clinical evidence, respect, inclusiveness, and compassion.
A clinical programme for gender healthcare has been initiated by the HSE and an updated clinical model for gender healthcare services is being developed. The Clinical lead is in place and recruitment is ongoing for the rest of the multi-disciplinary team.
A cross-speciality Clinical Advisory Group has been established with the Royal College of Physicians of Ireland and convened in June 2025 to support the Model of Care design and development. In addition, a working group, which has a number of representatives with direct lived experience has also been established and the first meeting took place in December 2025.
The HSE commenced the systematic review on the evidence base with respect to co-existing clinical needs in gender diverse people with support from the HSE Library Service. Interim results of this review were made available for public consultation during the month of August 2025. The HSE will now review submissions and complete the evidence review.
The other main element of the work will include a review of the experience base which encompasses an understanding of the experience of service users, their families, healthcare workers in gender healthcare and other stakeholders. As this is an area of healthcare where there are many public voices, all efforts will be made to hear from those with who have lived and living experience.
As the work progresses, the HSE will update their findings on the HSE website.
Lived experience engagement design sessions, attended by a number of advocacy groups, were held in July and September 2025. These sessions were held to inform the development of a plan to maximise stakeholder engagement.
Developing a Model of Care for Gender Healthcare Services is expected to be a complex process and the HSE and my department will work closely together to support the process, ensure transparency and keep the patient at the centre of the process.
It is important that the HSE is given time to develop a Model of Care that is based on the best clinical evidence and that will deliver the best outcomes for persons with gender incongruence or dysphoria. It is not possible to pre-empt the outcome of this process by determining at this stage what this model of care will look like once developed.
Regarding the HSE review of the Cass report, this was a specific and defined piece of work that was independent of the planned update of the HSE Clinical Model of Care for Gender Healthcare. It is the Model of Care that will ultimately make recommendations on the delivery of gender healthcare services in the HSE, for both adults and young people.
1033. Deputy Ken O'Flynn asked the Minister for Health what interim clinical governance, safeguards, or policy instructions are currently in place for the provision of gender healthcare services to children and adolescents pending the publication and consideration of the completed expert group assessment of the Cass Review; whether any changes to clinical practice have been paused, amended, or permitted during this interim period; and if she will make a statement on the matter. [9415/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1034. Deputy Ken O'Flynn asked the Minister for Health to outline the Department’s formal policy and methodology for evaluating international clinical guidance prior to its consideration or adoption within national healthcare frameworks; whether any such formal evaluation was undertaken in respect of the WPATH Standards of Care between 2018 and 2023; and if she will make a statement on the matter. [9416/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1035. Deputy Malcolm Byrne asked the Minister for Health the number of staff directly responsible for cybersecurity, as distinct from IT, within her Department; if a threat analyst, vulnerability manager and a cyber infrastructure engineer are employed; if not in-house, if this work is outsourced; and if she will make a statement on the matter. [9433/26]
View answerMy Department implements a multi-layered approach to cybersecurity, with comprehensive arrangements in place to support ICT security through specialised software, incident response plans, and continuous system monitoring.
For operational and security reasons, My Department does not disclose the specific number of staff directly responsible for cybersecurity, nor does it provide details on individual roles such as threat analyst, vulnerability manager, or cyber infrastructure engineer. My Department recognises the need for external expertise where necessary and maintains contracts with external parties to provide preventative controls and expertise, supplementing internal resources as needed.
1036. Deputy Malcolm Byrne asked the Minister for Health the extent to which her Department examines third party supply chain vulnerability when it comes to cybersecurity. [9451/26]
View answerMy Department manages its third-party supply chain using a risk-based approach. Each procurement contract includes information security measures, including cyber security, relevant to our risk appetite and the type of information handled.
My Department has commenced preparatory work to comply with the NIS2 Directive, which is expected to be incorporated into Irish law later this year. This will further address third-party risk management processes.
1037. Deputy Malcolm Byrne asked the Minister for Health the supports in place from her Department to assist section 39 organisations to become more cyber resilient; and if she will make a statement on the matter. [9463/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
